Polygraphic evaluation of the effects of functional orthodontic treatment with twin block and herbst appliances on sleep quality: a randomized clinical trial.
The aim of this clinical study was to investigate the effects of functional treatment with twin block (TB) and Herbst appliances on sleep quality.
A total of 46 patients having mandibular retrognathia and identified with OSA were divided randomly into two groups: Twin Block (TB) and Herbst appliances. Changes in sleep parameters (apnoea-hypopnea index (AHI), supine AHI, oxygen desaturation index (ODI), minimum oxygen saturation) at baseline (B/L) and an average of 8-month follow-up (F/U) detected by polygraphy and Pittsburgh Sleep Quality Index (PSQI) were the primary outcomes. Treatment of the mandibular retrognathia was the secondary outcome. Shapiro Wilk test and Q-Q graphs were used to evaluate the distribution of variables according to groups, Mann Whitney U test was used to evaluate the two independent group means of measurements. Paired sample t test was used to evaluate the differences between the B/L and F/U times at p < 0.05 significance level.
Among 46 patients randomized, AHI changed from B/L to F/U in Herbst group statistically significant (1.08 (-0.47-2.63), p = 0.031). While the change from B/L to F/U in the supine AHI was significant in Herbst group (3.29 (-0.20-6.78), 95% (CI), p = 0.001), this value did not reach statistical significance in TB group (0.39 (-0.59-1.37), 95% (CI), p = 0.531). ODI altered from B/L to F/U in Herbst group statistically significant (2.09 (0.58-3.60), p = 0.013). There was no change in minimum oxygen saturation following treatment in all groups (3.81 (-1.38-9.00), p = 0.166; 0.87 (-3.17-4.91), p = 0.680, respectively). The F/U values of SNB, ANB and Wits were statistically significantly higher than the B/L values (95% (CI), p < 0.001) in both groups. The average PSQI values were decreased significantly in both groups following functional treatment (95% (CI), p < 0.05).
Significant improvement was observed in sleep parameters with Herbst appliance. Functional orthodontic treatment was found to be effective for adjunctive treatment for OSA. Changes in skeletal sagittal measurements were significant in all groups.
A total of 46 patients having mandibular retrognathia and identified with OSA were divided randomly into two groups: Twin Block (TB) and Herbst appliances. Changes in sleep parameters (apnoea-hypopnea index (AHI), supine AHI, oxygen desaturation index (ODI), minimum oxygen saturation) at baseline (B/L) and an average of 8-month follow-up (F/U) detected by polygraphy and Pittsburgh Sleep Quality Index (PSQI) were the primary outcomes. Treatment of the mandibular retrognathia was the secondary outcome. Shapiro Wilk test and Q-Q graphs were used to evaluate the distribution of variables according to groups, Mann Whitney U test was used to evaluate the two independent group means of measurements. Paired sample t test was used to evaluate the differences between the B/L and F/U times at p < 0.05 significance level.
Among 46 patients randomized, AHI changed from B/L to F/U in Herbst group statistically significant (1.08 (-0.47-2.63), p = 0.031). While the change from B/L to F/U in the supine AHI was significant in Herbst group (3.29 (-0.20-6.78), 95% (CI), p = 0.001), this value did not reach statistical significance in TB group (0.39 (-0.59-1.37), 95% (CI), p = 0.531). ODI altered from B/L to F/U in Herbst group statistically significant (2.09 (0.58-3.60), p = 0.013). There was no change in minimum oxygen saturation following treatment in all groups (3.81 (-1.38-9.00), p = 0.166; 0.87 (-3.17-4.91), p = 0.680, respectively). The F/U values of SNB, ANB and Wits were statistically significantly higher than the B/L values (95% (CI), p < 0.001) in both groups. The average PSQI values were decreased significantly in both groups following functional treatment (95% (CI), p < 0.05).
Significant improvement was observed in sleep parameters with Herbst appliance. Functional orthodontic treatment was found to be effective for adjunctive treatment for OSA. Changes in skeletal sagittal measurements were significant in all groups.